The purpose of this study is first, to describe the development and implementation of federal child health policy under Medicaid, with particular emphasis on the Early and Periodic Screening, Diagnosis, and Treatment (EPSDT) Program. The second objective is to analyze four hypothetical constraints on implementation of this policy: 1) differences in health and welfare agencies' roles and ideologies whic lead to conflicts in responsibilities; 2) federal inability to enforce its own laws and regulations in the states; 3) absence of state managerial ability to handle effective case management; and 4) lack of consensus among health professionals regarding the benefits of and standards for preventive pediatric care. The final objective is to determine whether these constraints, if they do exist, can be eliminated or their effects reduced.